ARDMS RVT Exam Prep: Study Guide and Practice
To earn RVT, you must meet ARDMS prerequisites and satisfy the SPI and Vascular Technology (VT) examination requirements. Below are the current VT topic weights, the criteria you must know, 30 original practice questions with explanations, and an 8-week plan.
Start here: one ABI in two minutes
Right ankle pressures are 120 mmHg (posterior tibial) and 114 mmHg (dorsalis pedis). Arm pressures are 150 mmHg on the right and 140 mmHg on the left.
Right ABI = higher right ankle pressure ÷ higher arm pressure = 120 ÷ 150 = 0.80. That is abnormal (0.90 or lower).
Two rules decide the answer: use the higher of the two ankle pressures on that leg, and divide by the higher brachial pressure from either arm. Pick the wrong number on either side and every answer choice will look plausible. Invented values; method from the SVU lower extremity arterial physiologic guideline, pp. 5–6; category from the 2024 ACC/AHA PAD guideline, official AHA slide set.
Next, try RVT-19 below with a different set of numbers.
By the Castleport Test Prep Editorial Team · Official exam facts last verified October 28, 2026 · How we create study material
Jump to: Criteria to know cold · 30 practice questions · 8-week plan · Exam facts
Where the VT points are
| Domain (VT Content Outline v24.1) | Weight | ≈ Questions* | What you must be able to do |
|---|---|---|---|
| 2. Pathology, Perfusion, and Function | 32% | ~54 | Grade disease in carotid, intracranial, limb, venous, aortoiliac, renal, mesenteric, and hepatoportal vessels; spot critical and incidental findings |
| 1. Normal Anatomy, Perfusion, and Function | 21% | ~36 | Know normal anatomy and normal spectral, color, and power Doppler patterns in every vascular bed, including vein mapping and TCD/TCI |
| 6. Quality Assurance, Safety, and Physical Principles | 14% | ~24 | Fix artifacts, apply Doppler physics, calculate resistive index and acceleration time, choose protocols, correlate with CT, MRI, and angiography |
| 4. Physiologic Exams | 12% | ~20 | Calculate ABI and segmental pressures by hand, run exercise and provocative tests, choose cuffs and PPG sensors, run venous PPG with tourniquets |
| 7. Preparation, Documentation, and Communication | 8% | ~14 | Confirm patient and history, adapt to the patient, document findings and technical limitations, follow the critical-findings protocol |
| 5. Ultrasound-guided Procedures/Intraoperative Assessment | 7% | ~12 | Guide pseudoaneurysm compression and thrombin injection, guide venous ablation, image before, during, and after procedures |
| 3. Surgically Altered Anatomy and Pathology | 6% | ~10 | Evaluate dialysis access, bypass grafts, stents, EVAR, TIPS, IVC filters, ablated veins, and transplanted organs |
*Our arithmetic: each published percentage applied to the approximately 170 questions ARDMS lists, then rounded. ARDMS publishes percentages, not per-domain counts, so use these for planning only. Weights from the VT Content Outline v24.1, page 1; question count from the Inteleos VT exam page.
More than half the exam (Domains 1 and 2, 53% together) asks one thing across every vascular bed: is this normal, and if not, how bad is it? Physiologic Exams plus Quality Assurance, Safety, and Physical Principles add another 26%. Build your study around criteria you can apply, not facts you can recite.
Criteria you must know cold
The public VT content outline specifies topics, not a single diagnostic-criteria table for every question. Laboratories apply documented criteria adopted from published guidance or validated locally. The tables below identify the consensus or guideline behind each set of values. Learn them, and learn which measurement is primary.
Carotid stenosis: SRU consensus and the 2023 IAC update
The 2003 Society of Radiologists in Ultrasound (SRU) consensus below applies to native extracranial ICA atherosclerotic disease without prior intervention. ICA peak systolic velocity (PSV) and the plaque estimate are the primary parameters. The ICA/CCA PSV ratio and ICA end-diastolic velocity (EDV) are additional parameters.
| ICA stenosis | ICA PSV | Plaque estimate | ICA/CCA PSV ratio | ICA EDV |
|---|---|---|---|---|
| Normal | < 125 cm/s | None | < 2.0 | < 40 cm/s |
| < 50% | < 125 cm/s | < 50% | < 2.0 | < 40 cm/s |
| 50–69% | 125–230 cm/s | ≥ 50% | 2.0–4.0 | 40–100 cm/s |
| ≥ 70% but less than near occlusion | > 230 cm/s | ≥ 50% | > 4.0 | > 100 cm/s |
| Near occlusion | High, low, or undetectable | Visible | Variable | Variable |
| Total occlusion | Undetectable | Visible, no detectable lumen | N/A | N/A |
Source: Grant et al., SRU consensus, Radiology 2003, Table 3.
The 2023 update. The Intersocietal Accreditation Commission (IAC) now strongly recommends that accredited labs use a modified SRU table. It raises the PSV threshold for a 50% stenosis from 125 to 180 cm/s. It also notes that a PSV of 125–180 cm/s with an ICA/CCA ratio of 2.0 or higher can be consistent with 50–69% stenosis when plaque and other stenosis findings support it. The principal Doppler thresholds for ≥ 70% stenosis were not changed, and IAC says all Doppler and gray-scale parameters should be considered (IAC, November 2023, p. 1).
On test day, read what the question gives you. Every carotid item in our set below has the same answer under either table.
ABI and TBI (2024 ACC/AHA PAD guideline)
- ABI = higher ankle pressure (DP or PT) on that leg ÷ higher of the two brachial pressures
- TBI = great-toe pressure ÷ higher brachial pressure
| Resting ABI | Report as |
|---|---|
| ≤ 0.90 | Abnormal |
| 0.91–0.99 | Borderline |
| 1.00–1.40 | Normal |
| > 1.40 | Noncompressible |
- A TBI of 0.70 or less is abnormal.
- If the ABI is noncompressible and PAD is suspected, get toe pressures/TBI with waveforms.
- If chronic symptomatic PAD is suspected because of exertional, nonjoint-related leg symptoms despite a normal or borderline resting ABI, exercise treadmill ABI is recommended after assessing the patient's suitability under the lab's protocol.
Sources: 2024 ACC/AHA multisociety PAD guideline, official AHA slide set, Figure 2 and resting/exercise ABI recommendations; SVU arterial physiologic guideline, exercise testing protocol.
The SVU protocol is broader about when toes are required. It calls for toe pressures, TBI, and digital PPG waveforms with diabetes, chronic kidney disease, suspected medial calcification, resting ABI > 1.30, noncompressible vessels, rest pain, or a nonhealing wound. In those patients, a normal ABI does not exclude PAD (SVU, p. 6). Keep the two straight: one is a reporting category, the other is a lab protocol trigger.
Venous reflux (2022 SVS/AVF/AVLS guideline)
| Veins | Reflux duration threshold |
|---|---|
| Superficial truncal veins (GSV, SSV, accessory saphenous), tibial, deep femoral, perforating | > 500 ms |
| Common femoral, femoral, popliteal | > 1 second |
Source: 2022 SVS/AVF/AVLS guideline, Part I, 1.1.a. The earlier 2003 study used > 350 ms for perforators; the 2022 guideline uses > 500 ms.
DVT exam essentials
- The 2018 SRU consensus prefers a single complete duplex exam from thigh to ankle, with Doppler at selected sites, over limited or compression-only exams. It calls residual material after a past DVT chronic postthrombotic change (Needleman et al., Circulation 2018).
- SVU's 2026 protocol recommends transverse compression every 2 cm, when not contraindicated. Its minimum list includes the calf veins (posterior tibial, peroneal, gastrocnemius) and both saphenous veins. When thrombus is present, document whether the segment is partially or totally noncompressible (SVU venous guideline, pp. 5–6).
Abdominal and aortic numbers
| Finding | Criterion or expected finding |
|---|---|
| Abdominal aortic aneurysm | Infrarenal diameter ≥ 3.0 cm (or ≥ 1.5× the diameter of the more proximal infrarenal aorta); the AIUM/SVU convention measures outer wall to outer wall (AIUM parameter, 2021; SVU screening guideline, 2026, p. 3) |
| Native renal artery stenosis ≥ 60% | RVT-14 uses a stated laboratory protocol requiring renal PSV ≥ 180 cm/s and renal-aortic ratio (RAR) ≥ 3.5. Published protocols vary; apply the laboratory's documented criteria and distinguish native arteries from stents (original validation research; SVU renal guideline, pp. 5–6) |
| Fasting SMA | High-resistance waveform; becomes low-resistance after a meal (CSVS protocol) |
| Celiac artery | Low-resistance waveform even when fasting (same source) |
| Main portal vein | Normally hepatopetal (toward the liver). Hepatofugal flow in cirrhosis usually means advanced portal hypertension (SVM/SVU waveform consensus, Tables 16–17) |
Formulas you will use
| Formula | Use |
|---|---|
| ABI = higher ankle ÷ higher brachial | PAD category |
| TBI = great-toe pressure ÷ higher brachial | Calcified or noncompressible vessels |
| ICA/CCA ratio = ICA PSV ÷ CCA PSV | Carotid grading |
| RAR = renal artery PSV ÷ aortic PSV | Renal stenosis |
| RI = (PSV − EDV) ÷ PSV | Waveform index influenced by vascular resistance, compliance, and systemic hemodynamics |
| Doppler shift = 2 × f₀ × v × cos θ ÷ c | Why angle matters: cos 0° = 1, cos 60° = 0.5, cos 90° = 0 |
| Nyquist frequency limit = PRF ÷ 2 | Aliasing threshold for pulsed and color Doppler |
For carotid duplex velocity measurements, use an angle of 60° or less; SVU says angles greater than 60° must be avoided (SVU extracranial guideline, p. 5). In the Doppler equation, f₀ is transmitted frequency, v is blood velocity, θ is the beam–flow angle, and c is sound speed; use consistent units. PRF means pulse repetition frequency. Sources for the rest: ASE Doppler quantification, 2002, equations 1–2; ASE 2019, pulsed-wave Doppler physics; renal RI study, Methods; RI resistance/compliance experiment.
Signs worth recognizing on sight
- Pseudoaneurysm: echolucent sac beside an artery, "yin-yang" swirl in the sac on color, "to-and-fro" spectral flow in the neck (ASE vascular cannulation guideline, section 6.3).
- Complete subclavian steal: retrograde flow in the vertebral artery on the side of a proximal subclavian stenosis or occlusion, with a dampened arm waveform on that side (SVM/SVU waveform consensus, Table 11).
- Tardus parvus: slow systolic upstroke and a low, rounded peak downstream of a stenosis, such as in renal or hepatic arteries (SVM/SVU waveform consensus, Tables 7, 14–15).
- Type II endoleak: retrograde flow into the aneurysm sac after EVAR from the inferior mesenteric or lumbar arteries. It is the most common endoleak type (CIRSE endoleak standards, Type II definition).
30 free RVT practice questions
These questions are original and unofficial. Castleport wrote them; they are not ARDMS exam questions, and your score on them does not predict your exam result. The real VT exam also uses hotspot questions, where you mark the answer on an image. This set is text only, so practice reading images separately. AIUM's free extracranial image examples provide a place to practice identifying carotid anatomy and Doppler findings.
The set roughly reflects the outline weights: Domain 1 (6), Domain 2 (10), Domain 3 (2), Domain 4 (4), Domain 5 (2), Domain 6 (4), Domain 7 (2). It samples all seven domains, not every outline task. Pick an answer before you open the explanation.
Domain 1: Normal Anatomy, Perfusion, and Function
RVT-01 · Domain 1
During a carotid duplex, which pair of findings best identifies a vessel as the internal carotid artery rather than the external carotid artery?
Show answer and explanation
Answer: B. The ICA supplies the brain, a low-resistance bed, so flow continues forward through diastole, and the ICA normally has no branches in the neck. A describes the ECA, which branches in the neck and feeds higher-resistance tissue. C points toward the ECA, but the temporal tap is not definitive: in one study, tap oscillations also appeared in about a third of ICAs. D is the ECA's more pulsatile pattern.
Sources: SVM/SVU waveform consensus, Tables 10–11; original cervical ICA anatomy study; temporal tap study, Radiology
RVT-02 · Domain 1
A patient fasted overnight and has a normal superior mesenteric artery (SMA) with usual branching anatomy. What spectral waveform do you expect, and what happens after a meal?
Show answer and explanation
Answer: B. The fasting SMA feeds resting bowel and shows a high-resistance waveform. Digestion lowers bowel resistance, so after a meal the SMA turns low-resistance. A reverses the physiology. C describes the celiac artery, which feeds the liver and spleen. (One trap: if the right hepatic artery comes off the SMA, the fasting SMA can look low-resistance.) D describes a vein.
RVT-03 · Domain 1
What is the normal direction of flow in the main portal vein?
Show answer and explanation
Answer: B. Normal portal flow is hepatopetal. In cirrhosis, persistent hepatofugal flow suggests advanced portal hypertension. C describes reversed pulsatile flow, which can happen with tricuspid regurgitation. D is wrong: portal flow normally persists throughout the cardiac cycle, and a meal increases it rather than starting it.
Sources: SVM/SVU waveform consensus, Tables 16–17; original meal/portal-flow study; original tricuspid-regurgitation study
RVT-04 · Domain 1
In a right ICA, PSV is 95 cm/s, EDV is 25 cm/s, the ICA/CCA ratio is 1.4, and no plaque or wall thickening is visible. How do you categorize it?
Show answer and explanation
Answer: A. The velocities fit both "normal" and "< 50%." Plaque is what separates them: no visible plaque means normal. This holds under the original SRU table and the 2023 IAC modification. B needs visible plaque or intimal thickening with less than 50% diameter reduction. C needs a much higher PSV. D mixes in a renal measurement that has nothing to do with carotid grading.
RVT-05 · Domain 1
In a technically good transverse view, the walls of one clearly identified segment of the femoral vein meet completely under probe pressure. What does this finding, by itself, show?
Show answer and explanation
Answer: C. A compression finding applies to the segment you compressed. That is why SVU recommends transverse compression every 2 cm, when not contraindicated, including assessment of the calf veins. A stretches one finding over veins you have not examined. B needs a separate reflux assessment with reversed-flow timing. D is not something compression can tell you.
RVT-06 · Domain 1
At rest, what Doppler waveform do you expect in a normal brachial artery without an AV access or another cause of increased flow demand?
Show answer and explanation
Answer: A. Resting arm muscle is a high-resistance bed, so a normal brachial artery shows a multiphasic, typically triphasic, waveform. B can occur with upstream flow-limiting disease, especially when the systolic upstroke is delayed, but low resistance can also result from increased flow demand or an arteriovenous fistula. C is a venous pattern. D is the signature of a pseudoaneurysm neck.
Domain 2: Pathology, Perfusion, and Function
RVT-07 · Domain 2
Left native, nonstented ICA: PSV 260 cm/s, EDV 115 cm/s, ICA/CCA ratio 4.6. Plaque causes more than 50% visible lumen narrowing, and gray-scale and color assessment exclude near occlusion. What is the stenosis category?
Show answer and explanation
Answer: C. PSV over 230 cm/s, ratio over 4.0, and EDV over 100 cm/s all point to 70% or more short of near occlusion. The SRU and 2023 IAC tables agree on this row. A and B do not fit the combined findings under these criteria. D usually shows a markedly narrowed lumen with velocities that can be high, low, or undetectable, so it is not defined by a high PSV alone.
RVT-08 · Domain 2
Right native, nonstented ICA: PSV 170 cm/s, EDV 55 cm/s, ICA/CCA ratio 2.8, and plaque estimated at more than 50% diameter reduction. Poststenotic turbulence is present, and imaging excludes near occlusion. What is the stenosis category?
Show answer and explanation
Answer: C. Under the SRU table, every value falls in the 50–69% band. Under the 2023 IAC update, a PSV of 125–180 cm/s with a ratio of 2.0 or higher and the supporting plaque/turbulence findings is also consistent with 50–69%, so both tables agree. A and B fit neither table here: the ratio and plaque are too high. D does not fit the combined findings under these criteria; near occlusion has been excluded.
Sources: original SRU consensus, Table 3; IAC 2023 update, table footnote
RVT-09 · Domain 2
A patient with dizziness has retrograde flow in the left vertebral artery and a monophasic left brachial waveform. The right side is normal. What is the most likely cause?
Show answer and explanation
Answer: B. When the subclavian artery is badly narrowed or blocked before the vertebral artery branches off, the arm draws blood backward down the vertebral artery on that side. The arm waveform on that side becomes dampened. A affects carotid flow and does not explain the arm. C can change vertebral flow but would not make the brachial signal monophasic. D sits downstream of the vertebral origin and would not reverse vertebral flow.
RVT-10 · Domain 2
During a venous insufficiency study, which single finding meets the 2022 SVS/AVF/AVLS definition of pathologic reflux?
Show answer and explanation
Answer: C. Superficial truncal veins like the GSV are pathologic at more than 500 ms, so 0.7 seconds counts. A, B, and D are in the common femoral, femoral, or popliteal veins, which need more than 1 second of reversed flow. The trap is using the superficial cutoff on the deep axial veins.
RVT-11 · Domain 2
For a patient with suspected acute lower-extremity DVT, which exam does the 2018 SRU multidisciplinary consensus prefer?
Show answer and explanation
Answer: C. The panel recommended a single complete duplex exam from thigh to ankle, calf veins included, with Doppler at selected sites. A and B are limited exams that can miss calf thrombus; the panel accepted extended compression only as a point-of-care fallback that is followed later by a complete exam. D samples one site and cannot exclude DVT.
RVT-12 · Domain 2
In a technically adequate transverse view, a femoral vein segment contains echogenic material, and its walls do not fully meet under compression. Color flow fills part of the lumen around the material. What is the best interpretation?
Show answer and explanation
Answer: B. Partial flow and incomplete compression can coexist. The structural finding still counts, and protocols ask you to document whether a segment is partially or totally noncompressible. A and D ignore the compression finding. C claims an age that residual flow alone cannot establish; aging thrombus relies on other features and the full exam, and may remain indeterminate.
Sources: SVU venous guideline, p. 6; SRU DVT consensus, thrombus terminology
RVT-13 · Domain 2
On an AAA screening exam using the AIUM/SVU outer-wall-to-outer-wall convention, the infrarenal aorta measures 3.4 cm. How should this be categorized?
Show answer and explanation
Answer: C. The AIUM infrarenal screening definition is a diameter of at least 3.0 cm (or at least 1.5 times the more proximal infrarenal aorta), and the AIUM/SVU convention measures outer edge to outer edge. A mistakes a surveillance band for the definition. B does not fit this 3.4-cm measurement. D is wrong for the AIUM/SVU measurement convention used here.
Sources: AIUM abdominal aorta parameter, 2021, examination specifications; SVU AAA screening guideline, 2026, p. 3
RVT-14 · Domain 2
For this technically adequate native renal artery examination, the laboratory's specified criteria for ≥ 60% stenosis require PSV ≥ 180 cm/s and RAR ≥ 3.5. Renal artery PSV is 240 cm/s, and aortic PSV at the renal level is 60 cm/s. What do these values suggest?
Show answer and explanation
Answer: B. RAR = renal PSV ÷ aortic PSV = 240 ÷ 60 = 4.0. Both the PSV (180 cm/s or more) and the RAR (3.5 or more) meet the criteria specified in the stem for 60% or greater stenosis. A flips the ratio. C miscalculates it. D would show no flow through the occluded segment, not high velocity.
Sources: AbuRahma et al., original renal duplex validation research; SVU renal artery duplex guideline, pp. 5–6; SVM/SVU waveform consensus, renal waveforms
RVT-15 · Domain 2
A patient with cirrhosis has continuous flow in the main portal vein directed away from the liver. What does this most often indicate?
Show answer and explanation
Answer: B. Continuous hepatofugal portal flow in cirrhosis points to advanced portal hypertension. A is wrong because meals increase flow toward the liver. C would mean no flow through the completely occluded segment; persistent flow through the assessed portal lumen shows that it is patent. D affects the hepatic artery, not the direction of portal flow.
Sources: SVM/SVU waveform consensus, Tables 16–17; original meal/portal-flow study
RVT-16 · Domain 2
After a cardiac catheterization, a patient has a pulsatile groin mass. You see an anechoic sac beside the common femoral artery with swirling red-blue color, and the channel connecting the sac to the artery shows flow going both ways. What is it?
Show answer and explanation
Answer: C. The classic triad is an echolucent sac next to the artery, a yin-yang color pattern in the sac, and to-and-fro flow in the neck. A shows turbulent flow between an artery and a vein, with pulsatile flow in both, not a sac. B has no flow inside it. D typically has an echogenic center with organized flow at its hilum.
Sources: ASE vascular cannulation guideline, section 6.3; SRU superficial soft-tissue mass consensus, lymphadenopathy
Domain 3: Surgically Altered Anatomy and Pathology
RVT-17 · Domain 3
On a surveillance scan after EVAR, color Doppler shows flow in the aneurysm sac that enters backward through a lumbar artery. Which endoleak type is this?
Show answer and explanation
Answer: B. Type II endoleaks come from backward flow through branch arteries, most often the inferior mesenteric or lumbar arteries, and they are the most common type. A is a leak where the graft attaches. C comes from a defect or separation between graft pieces. D is flow through the porous graft fabric.
RVT-18 · Domain 3
An operative note says a synthetic tube was placed connecting an artery to a vein in the arm for hemodialysis. Which description fits, and what does the study need to cover?
Show answer and explanation
Answer: C. A synthetic tube between an artery and a vein is an AV graft. A native AV fistula connects the artery and vein directly, with no tube, which rules out A (and A's narrow coverage misses most of the circuit). B changes the stated endpoints. D ignores the surgery. Reconstruct the circuit first, then examine each part of it: inflow, both connections, the graft, and outflow.
Sources: NIDDK, hemodialysis vascular access; SVU hemodialysis access guideline, p. 6
Domain 4: Physiologic Exams
RVT-19 · Domain 4
Brachial pressures: right 132 mmHg, left 148 mmHg. Left ankle: dorsalis pedis 84 mmHg, posterior tibial 76 mmHg. What is the left ABI, and what category is it?
Show answer and explanation
Answer: A. Use the higher ankle pressure on that leg (84) over the higher brachial pressure from either arm (148): 84 ÷ 148 = 0.57, which is 0.90 or less and abnormal. B divides by the lower brachial pressure (84 ÷ 132). C uses the lower ankle pressure (76 ÷ 148). D flips the ratio.
Sources: SVU arterial physiologic guideline, pp. 5–6; 2024 PAD guideline, official AHA slide set
RVT-20 · Domain 4
A patient with long-standing diabetes and a nonhealing toe wound has an ABI of 1.52. What is the most appropriate next physiologic test?
Show answer and explanation
Answer: B. An ABI over 1.40 means the ankle arteries are noncompressible, usually from calcification, so the ABI can be falsely elevated. Both the 2024 PAD guideline and the SVU protocol call for toe pressures/TBI here. A is the classic trap. C does not fix calcification, and a cuff that is too narrow falsely raises pressure. D tests venous reflux, not arterial flow.
Sources: 2024 PAD guideline, official AHA slide set; SVU arterial physiologic guideline, pp. 2 and 6
RVT-21 · Domain 4
Great-toe pressure is 62 mmHg, and the higher brachial pressure is 140 mmHg. How do you interpret the toe-brachial index?
Show answer and explanation
Answer: A. TBI = 62 ÷ 140 = 0.44. A TBI of 0.70 or less is abnormal under the 2024 guideline. B is the trap: 0.44 is below the guideline threshold for an abnormal TBI. C flips the ratio. D treats the raw toe pressure as if it were a ratio.
RVT-22 · Domain 4
Venous photoplethysmography (PPG) shows an abnormally short refill time without a tourniquet. With a tourniquet applied to block the superficial veins, the refill time becomes normal. What does this suggest?
Show answer and explanation
Answer: B. The tourniquet shuts off the superficial veins. If refill time returns to normal, this suggests that superficial reflux contributed to the rapid refill. Persistent abnormal refill would require further evaluation; PPG alone cannot prove an exclusively deep lesion. A does not fit the normalization described here. C is not what venous PPG measures. D ignores the abnormal first result. PPG is sensitive but not very specific and cannot pinpoint where reflux is, so duplex is what localizes it.
Sources: original PPG/tourniquet study; air plethysmography, PPG, and duplex compared
Domain 5: Ultrasound-guided Procedures/Intraoperative Assessment
RVT-23 · Domain 5
After ultrasound-guided thrombin injection of a femoral pseudoaneurysm, which finding supports successful sac thrombosis?
Show answer and explanation
Answer: B. Absence of flow in the sac supports thrombosis. The native and distal arteries are also checked for thrombus or impaired flow. A smaller sac alone does not establish whether flow persists; C shows persistent sac flow. D describes clot in the native artery, a complication to check for and report, not a sign of success.
Sources: Bortolini et al., technical protocol and technical success; Chae et al., post-injection arterial assessment
RVT-24 · Domain 5
During supervised ultrasound-guided vascular access with a short-axis view, a bright dot from the needle is visible near the vessel, but you have not confirmed that it is the needle tip. What does the image establish?
Show answer and explanation
Answer: B. In a short-axis (out-of-plane) view, the beam can cross the needle shaft anywhere, so a bright dot is not proof of where the tip is. The tip has to be found and tracked. A and C claim locations the image does not show. D skips the step the guideline calls essential.
Domain 6: Quality Assurance, Safety, and Physical Principles
RVT-25 · Domain 6
A carotid velocity sample was recorded at a 70° Doppler angle, and a better probe position is available. What is the best action?
Show answer and explanation
Answer: C. SVU's protocol calls for an angle of 60° or less and says angles greater than 60° must be avoided. Near 90°, small angle errors cause large velocity errors because the velocity calculation divides by cos θ, which approaches zero. A keeps an unreliable value. B changes the label, not the actual angle between beam and flow, so the velocity becomes wrong. D changes brightness, not angle.
RVT-26 · Domain 6
Pulsed Doppler at an ICA stenosis shows the spectral peaks wrapping around to the bottom of the display. Which adjustment reduces this artifact?
Show answer and explanation
Answer: B. Wraparound is aliasing: the Doppler shift is above the Nyquist limit (PRF ÷ 2). Raising the scale raises the limit; shifting the baseline reallocates the displayed range but does not raise PRF. A lower-frequency transducer also helps. Continuous-wave Doppler avoids aliasing but loses depth specificity. A raises the shift and makes aliasing worse. Greater sample depth limits the maximum available PRF. D lowers the Nyquist limit.
Source: ASE 2019 comprehensive examination guideline, pulsed-wave Doppler and Table 1.18–1.19
RVT-27 · Domain 6
An intrarenal artery shows a PSV of 80 cm/s and an EDV of 20 cm/s. What is the resistive index?
Show answer and explanation
Answer: C. RI = (PSV − EDV) ÷ PSV = (80 − 20) ÷ 80 = 0.75. A is EDV ÷ PSV. B divides the difference by 100. D is PSV ÷ EDV.
RVT-28 · Domain 6
An external vascular transducer touched only clean, intact skin during an exam. What does the AIUM 2025 guideline require before the next patient?
Show answer and explanation
Answer: A. External transducers on clean, intact skin are noncritical devices: clean them, then do low-level disinfection, following the manufacturer's compatibility instructions. B is the rule for internal and intraoperative transducers. C skips cleaning; the guideline still requires low-level disinfection even for transducers used under covers in percutaneous procedures. D can damage the transducer, which the guideline warns can affect diagnostic results.
Source: AIUM transducer cleaning guideline, July 2, 2025, Section I
Domain 7: Preparation, Documentation, and Communication
RVT-29 · Domain 7
During an outpatient venous duplex, you find acute occlusive thrombus extending into the common femoral vein. What is the appropriate next step?
Show answer and explanation
Answer: B. The VT outline lists acute DVT, aneurysm, and critical stenosis as critical findings, and SVU guidelines say to alert the medical director or appropriate provider when immediate attention is needed, per department policy. A delays a time-sensitive result. C starts treatment without following the responsible provider and laboratory process. D is wrong for an acute finding.
Sources: VT Content Outline v24.1, tasks 2.A.14 and 7.B; SVU venous guideline, p. 7
RVT-30 · Domain 7
On a complete DVT exam, swelling and body habitus keep you from seeing the left peroneal veins adequately. How should you handle it?
Show answer and explanation
Answer: C. The peroneal veins are on the minimum compression list, so the interpreting physician needs to know they were not cleared. Guidelines and the VT outline both expect you to document exceptions and technical limitations. A reports something you did not see. B hides the gap. D invents a positive.
Sources: SVU venous guideline, pp. 5–6; VT Content Outline v24.1, task 7.B.1
Use your misses, not your score
Your result tells you how you did on these 30 items, nothing more. ARDMS reports a scaled score from 300 to 700, and a short original set cannot estimate it. Use what you missed to decide where to start:
| You missed | Start here |
|---|---|
| RVT-01 to 06 | Normal flow patterns in each bed; Weeks 2–5 of the plan |
| RVT-07, 08, 09 | Carotid criteria and subclavian steal; Week 2 |
| RVT-10, 11, 12 | Reflux thresholds and the DVT protocol; Week 4 |
| RVT-13 to 16 | Abdominal numbers and pseudoaneurysm signs; Weeks 5–6 |
| RVT-17, 18 | Surgically altered anatomy; Week 6 |
| RVT-19 to 21 | Arterial physiologic testing; Week 3 |
| RVT-22 | Venous PPG; Week 4 |
| RVT-23, 24 | Procedures; Week 6 |
| RVT-25 to 28 | Physics, QA, and safety; Week 1 and Week 7 |
| RVT-29, 30 | Documentation and communication; Week 7 |
Keep an error log. Writing down why you missed something turns a wrong answer into a specific fix.
| Question or concept | What I thought | What actually decides it | Next practice action | Revisit on |
|---|---|---|---|---|
| Example: RVT-19 | I divided by the right arm pressure | Use the higher brachial pressure from either arm | Rework the ABI example with a new higher arm pressure | Two days later |
Your 8-week RVT study plan
Assumes: you have finished (or are taking) SPI and can study about five 1-hour sessions a week, around 40 hours in all. This is our editorial plan, not an ARDMS requirement or a guarantee.
Most sessions: 10 minutes recalling the last session without notes, 30 minutes on the new topic, 15 minutes on questions, a calculation, or a sketch, and 5 minutes on your error log.
| Week | Focus (outline tasks) | What to finish |
|---|---|---|
| 1 | Hemodynamics and physical principles (6.B) | Doppler equation, angle correction, aliasing, RI and acceleration time. Take all 30 questions cold as a baseline and start your error log. |
| 2 | Cerebrovascular, normal and abnormal (1.A.10–11, 2.A.11–12) | Learn both carotid tables; ICA vs. ECA; vertebral flow and subclavian steal; TCD/TCI basics; incidental neck findings. Redo RVT-01, 04, 07–09. |
| 3 | Limb arteries and physiologic arterial testing (1.A.4–5, 2.A.5–6, 4.A) | ABI and TBI by hand with three new sets of numbers; segmental pressures; cuff-size effects; exercise testing; waveform changes above and below a lesion. Redo RVT-19–21. |
| 4 | Veins (1.A.2–3, 1.A.9, 1.A.12, 2.A.2–4, 2.A.10, 4.B) | Complete DVT protocol, partial vs. total noncompressibility, acute vs. chronic postthrombotic change, upper extremity and IVC/iliac disease, reflux thresholds, PPG with tourniquets, vein mapping. Retake all 30 questions. |
| 5 | Abdominal (1.A.1, 1.A.6–8, 2.A.1, 2.A.7–9) | Aortoiliac aneurysm and dissection, renal and mesenteric criteria, hepatoportal flow, Budd-Chiari, portal hypertension. Build a table: vessel → normal waveform → abnormal finding → limitation. |
| 6 | Surgically altered anatomy and procedures (Domains 3 and 5) | Sketch AV fistula vs. AV graft circuits; bypass grafts, stents, EVAR endoleaks, TIPS, IVC filters, ablation follow-up, transplants; pseudoaneurysm compression and thrombin guidance; needle-tip imaging. |
| 7 | QA, safety, protocol, and documentation (6.A, Domain 7) | Critical findings, technical limitations, transducer cleaning, correlating with CT, MRI, and angiography. Use one session for a 30-minute timed pass through the 30 questions on this page, then spend the remaining 30 minutes reviewing your reasoning and updating your error log. This is pacing practice with familiar questions, not a full-length mock exam. |
| 8 | Repair and rehearse | Re-study your two highest-priority topics from the error log, retake all 30 questions, review the criteria tables daily, and confirm your ID and test-center details. |
Three calculation sets for Week 3
These invented resting systolic pressures are in mmHg and assume technically valid measurements. Calculate the ABI and TBI for the stated leg; round to two decimal places. These are extra calculation drills, separate from the 30 questions above.
| Set | Leg | Right arm | Left arm | Dorsalis pedis | Posterior tibial | Great toe |
|---|---|---|---|---|---|---|
| A | Right | 130 | 140 | 126 | 112 | 84 |
| B | Left | 128 | 120 | 144 | 138 | 100 |
| C | Right | 146 | 152 | 176 | 168 | 76 |
Show calculation answers
- Set A: ABI = 126 ÷ 140 = 0.90; TBI = 84 ÷ 140 = 0.60.
- Set B: ABI = 144 ÷ 128 = 1.13; TBI = 100 ÷ 128 = 0.78.
- Set C: ABI = 176 ÷ 152 = 1.16; TBI = 76 ÷ 152 = 0.50.
For each ABI, choose the higher ankle pressure on the stated leg. For both indices, use the higher brachial pressure. Source: SVU arterial physiologic guideline, ABI/TBI calculation.
Adapting the plan
- Four weeks, working vascular tech: Allow about ten 1-hour sessions per week to preserve the 40-hour workload. Week 1 = physics + cerebrovascular; Week 2 = arterial + physiologic + venous; Week 3 = abdominal + altered anatomy + procedures; Week 4 = QA/documentation, the timed 30-question review, and repair. Do not skip physiologic testing and physics. Physiologic Exams plus Quality Assurance, Safety, and Physical Principles account for 26% of the published outline. If you rarely run PPG or calculate indices by hand, use the exercises to identify what needs more review.
- 30-minute sessions: split each session in two and stretch the plan to about 16 weeks, or keep 8 weeks with ten short sessions a week.
- Retaking after a failed attempt: use your official score report and this error log together. Spend the extra time on why you missed things, not on repeating answers you have memorized.
VT exam facts
| Item | Current official detail |
|---|---|
| Credential | Registered Vascular Technologist (RVT), administered by ARDMS through the Inteleos portal; testing at Pearson VUE |
| Exams required | SPI + VT, passed within five years of each other, in either order |
| VT format | About 170 questions in three hours; the official exam page also lists a five-minute survey. |
| Question types | Multiple choice, plus hotspot questions where you mark the answer on an image. ARDMS has a short video on answering hotspots. |
| Content outline | VT Content Outline version 24.1; seven domains, weights above |
| Scoring | Pass/fail on a 300–700 scale; 555 or higher passes. Not a percentage and not curved. |
| Results | Score report at the test center and in your Pearson account; posted to your Inteleos portal within one week |
| VT fee | $300, including a $100 non-refundable processing fee; another non-refundable $50 if you test outside the U.S., Canada, or Mexico |
| SPI | About 110 questions in two hours; $275 |
| When | Applications and testing are year-round |
| If you don't pass | Reapply after three days; you must wait 60 days to retest, and that wait cannot be waived |
| Recent results | 2025 global VT results: 70% of first-time takers passed, 45% of repeat takers, 63% overall. These are group rates, not a prediction for you. |
Sources: Inteleos VT exam page; fee schedule; retake and reapply guidelines; 2025 Global Exam Performance Summary, VT row; SPI exam page.
The five-year rule. The window counts by calendar year and starts the day after you pass your first exam. Pass SPI in March 2027, and you have until December 31, 2032, to pass VT. Miss it, and you retake the exam you already passed. The rule does not apply when you add a specialty to a certification you already hold (5-Year Rule).
Eligibility. Prerequisites depend on your education and clinical pathway. Check the SPI & Specialty prerequisites chart and the Inteleos Prerequisite Prep Tool before you apply. We cannot determine your eligibility.
Testing software. Use the tutorial linked under "Sample testing" on the official Pearson VUE ARDMS page to review the testing interface.
Common questions
Do I have to pass SPI before VT? No. You can take them in either order, but you need both within five years of each other to earn RVT. Once you pass SPI and keep your status active, you don't retake it to add more ARDMS credentials.
How hard is the VT exam? In 2025, 70% of first-time VT takers passed and 63% of all takers. The VT exam page lists earlier years too: first-time pass rates sat in the mid-70s in 2016–2018, then dipped to 66% in 2022 and 2023. Plan real study time.
My practice-test scores are good. Am I ready? A practice score only describes how you did on that set. Check whether you can explain why each wrong option is wrong, whether you can do calculations without notes, and whether you can read findings on images. Those carry over to the hotspot and scenario questions better than a familiar-question score.
Is RVT the same as RVS? No. RVS is the Registered Vascular Specialist credential from Cardiovascular Credentialing International (CCI), with its own exam. Confirm which one your employer or program wants before you register.
Are "real VT exam questions" sold online legitimate? Treat them as a red flag. Inteleos treats taking or offering review courses that claim to include live questions, and posting exam content, as cheating, and lists penalties up to credential revocation (Exam Security). Every question on this page is original.
What if I don't pass? You can reapply after three days but must wait 60 days to sit again. Use the official retake and reapply guidelines when planning the gap.
Keep going
- Haven't passed SPI yet? Use the official SPI exam page and content outline to plan that part of your preparation.
- Ready to apply and book? See the official application process and exam scheduling instructions.
- Waiting on a score? See the official notification of results and scoring instructions.
Sources
Official exam sources (ARDMS / Inteleos, Pearson VUE), checked October 28, 2026
- Vascular Technology (VT) exam page: format, scoring, fee, retest wait, historical pass rates
- VT Examination Content Outline, version 24.1: page 1 weights, pages 1–5 tasks
- RVT certification page
- SPI exam page
- Exam Fee Schedule
- Retake and reapply guidelines
- 5-Year Rule
- Prerequisites and SPI & Specialty prerequisites chart
- Passing standard
- Exam Security
- 2025 Global Exam Performance Summary: January 1–December 31, 2025, VT row
- Pearson VUE ARDMS page: official tutorial under “Sample testing”
- CCI Registered Vascular Specialist: the separate RVS credential
Clinical and technical sources for the criteria and explanations
- Original SRU carotid consensus, Grant et al., Radiology 2003, Table 3
- IAC Updated Recommendations for Carotid Stenosis Interpretation Criteria, November 2023
- 2024 ACC/AHA multisociety lower extremity PAD guideline, official AHA slide set: Figure 2 and resting/exercise ABI recommendations
- SVU professional performance guidelines, updated April 2026: lower extremity arterial physiologic, lower extremity venous duplex for obstruction, extracranial cerebrovascular duplex, AAA screening, renal artery duplex, hemodialysis access
- 2022 SVS/AVF/AVLS varicose vein guideline, Part I, 1.1.a; Labropoulos et al., 2003 definition of venous reflux
- Needleman et al., SRU consensus on ultrasound for lower extremity DVT, Circulation 2018
- SVM/SVU consensus on arterial and venous Doppler waveforms, 2020
- ASE Guidelines for Performing Ultrasound-Guided Vascular Cannulation, February 2025: sections 3.3–3.4 and 6.2–6.3
- AIUM transducer cleaning guideline, July 2, 2025 revision
- NIDDK, hemodialysis vascular access
- AIUM abdominal aorta parameter, 2021
- AbuRahma et al., original renal duplex validation research, 2012
- CSVS mesenteric artery duplex protocol, 2018
- Original cervical ICA anatomy study, 2017
- Original physiology studies: temporal artery tap, 1996; meal/portal-flow response, 1998; portal flow in tricuspid regurgitation, 1993
- SRU superficial soft-tissue mass consensus, 2022, lymphadenopathy
- CIRSE Standards of Practice on Management of Endoleaks, 2024
- Pseudoaneurysm treatment studies: Bortolini et al., 2025; Chae et al., 2021
- Venous PPG studies: Barthélémy et al., 1985; Bays et al., 1994
- Doppler physics: ASE Doppler quantification, 2002; ASE comprehensive examination guideline, 2019, pulsed-wave Doppler section
- Resistive index: Oliveira et al., 2019; Bude and Rubin, 1999, resistance/compliance experiment
Last verified October 28, 2026: official exam facts against the Inteleos and Pearson VUE pages above; criteria and explanations against the cited guidelines and literature. Developed with AI assistance. Sources and calculations were checked for this version; no credentialed professional review is claimed. This guide is for exam preparation and does not replace your lab's protocols or validated criteria. See how we create study material.
Castleport Test Prep is an independent exam prep publisher. We are not affiliated with, endorsed by, or approved by ARDMS, Inteleos, or APCA. The practice questions on this page are original and unofficial. ARDMS, RVT, SPI, VT, and related names are used to identify the exams and credentials they describe; trademarks belong to their respective owners.